The significance of PTV dose coverage on cancer control outcomes in early stage non-small cell lung cancer patients treated with highly ablative stereotactic body radiation therapy

The British Journal of Radiology
Narek ShaverdianPercy Lee

Abstract

We evaluated whether patients with early-stage non-small-cell lung cancers (NSCLCs) treated with stereotactic body radiation therapy (SBRT) without full prescription dose coverage of the planning target volume (PTV) had inferior outcomes. The SBRT regimen was 54 Gy in three fractions. Dosimetric constraints were as per the Radiation Therapy Oncology Group 0236 guidelines. All patients underwent four-dimensional CT (4D-CT) simulation. The internal target volume (ITV) was defined using 4D-CT, and the PTV was defined as a 6-mm longitudinal and a 3-mm axial expansion from the ITV. If normal tissue constraints were beyond tolerance, ITV-based dosing was employed where priority was made for full ITV coverage at the expense of PTV coverage. Patients with and without full PTV dose coverage were compared, and control rates were estimated using Kaplan-Meier analysis. 120 NSCLC cases were evaluated with 81% having adequate PTV dose coverage. ITV and PTV were significantly larger in the cohort with inadequate PTV dose coverage (p = 0.0085 and p = 0.0038, respectively), and the mean ITV and PTV doses were higher in patients with adequate PTV dose coverage (p = 0.002 and p < 0.0001, respectively). The 3-year local control rate was 100% for b...Continue Reading

References

Jul 19, 2007·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Hiroshi OnishiTsutomu Araki
Nov 26, 2009·Physics in Medicine and Biology·Thomas KünzlerDietmar Georg
Mar 18, 2010·JAMA : the Journal of the American Medical Association·Robert TimmermanHak Choy
Apr 20, 2010·The Journal of Thoracic and Cardiovascular Surgery·Traves D CrabtreeJeffrey D Bradley
Jun 11, 2011·International Journal of Radiation Oncology, Biology, Physics·Jian ZhangJuan Wang
Aug 30, 2012·International Journal of Radiation Oncology, Biology, Physics·Ryan BakerThomas J Dilling
Mar 19, 2014·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Larry KestinUNKNOWN Elekta Lung Research Group

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Citations

Mar 1, 2017·International Journal of Radiation Oncology, Biology, Physics·Jing Zeng, Simon S Lo
Oct 31, 2019·Expert Review of Anticancer Therapy·Michael T MilanoFeng-Ming Spring Kong
Nov 23, 2017·The British Journal of Radiology·David H ThomasDaniel Low
Aug 11, 2020·International Journal of Radiation Oncology, Biology, Physics·Carlo GrecoZvi Fuks

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